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Organization
LIFE ESSENTIAL LLC
Active
Organization
LIFE ESSENTIAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RODERICK D HOLLOMON JR. PARAMEDIC (PHLEBOTOMIST)
(954) 907-0920
Entity
Organization
Contact information
Practice address
5851 HOLMBERG RD APT 3122, PARKLAND, FL 33067-4516
(754) 422-3608
Mailing address
6574 N STATE ROAD 7 # 344, COCONUT CREEK, FL 33073-3625
(754) 422-3608
Taxonomy
Speciality
Code
Description
License number
State
174200000X
Meals Provider
—
—
251E00000X
Home Health Agency
Primary
—
—
332U00000X
Home Delivered Meals
—
—
347C00000X
Private Vehicle
—
—
Other
Enumeration date
11/02/2022
Last updated
11/02/2022
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